Medicare And Medicaid Reform IS Possible: Just Put ME In Charge

This thread began as a post in reply to the ATS thread about N.J. Governor Chris Christie saying that a family of three making $5,137 a year is "too rich" to receive Medicaid. Those who know me know that once I get going on a subject, it's hard for me to stop writing. My response kind of went a little beyond the scope of the original OP, so I decided to create a new thread on the subject.

Gov. Christie should REALLY be forced to live on $6000 for a year so he can get a grasp on what it's like for the poor and disabled. He pays for very little of the life he leads now, even relying on state tax dollars to chopper himself to his son's ball games. What ARROGANCE!

He should also lay off the doughnuts, but that's another thread altogether.

He doesn't have a clue what it is like to live below the poverty level - for whatever reason - and I'd bet a pretty penny most of you folks that are calling for Medicare and Medicaid to be cut don't either. Do you really think people want to be living hand to mouth just so they can avoid work and get free stuff? PuLEEEZE. Dame un descanso.

What needs to happen is a little big of reform and accountability, especially holding Big Pharma accountable. Texas recently won a $170 million dollar judgment against a drug manufacturer for defrauding Medicaid, and yesterday Johnson and Johnson was ordered to pay South Carolina 327 million dollars for defrauding the state using "deceptive practices."

Put ME in charge of overhauling Medicare and Medicaid, and I will EXPAND services while CUTTING costs. It's really not that difficult. All you have to do is approach the job with common sense and a eye toward fairness to both the consumer and the providers. Of course it's hard to keep your eye on anything when your nose is stuck up Big Pharma's butt. I wouldn't have that problem.

I'll give you just a couple of for instances:

Here in South Carolina, Medicaid used to pay for dental hygiene visits (cleaning) twice a year at a cost of $60, and fillings if the need arose, also at a cost of $60. They also paid dentists $120 for extractions of infected teeth. That's all gone now. So what happens now if someone develops an abscess? They have wait until the infection becomes life threatening in order to go to the emergency room and be hospitalized for septicemia. I'd quote a figure for that, but there is really no way to guesstimate how much a week in the hospital will cost; however I'm willing to bet that it will be AT LEAST $10,000 dollars. And who pays for that? The taxpayer that's who, because the poor sure can't pay it. Basically, the way Medicaid is structured is a farce. Anyone recall the truism, "An ounce of prevention is worth a pound of cure?"

Drug costs. I'm currently working on a story (for those who don't know, I'm a freelance journalist) about the rules and laws the DEA are forcing down the throats of physicians in the name of the failed "War on Drugs." Physicians are forced to jump through all kind of hoops, and even prescribe unnecessary medications, to provide care for those in chronic pain. In order to prevent "abuse" - less than 3% of chronic pain patients abuse their medications - the DEA uses the idea that it's some kind of epidemic to force doctors to prescribe the latest medications, which are designed to prevent abuse (and maximize profit for Big Pharma,) instead of using cheap generics which are just as, if not more, effective.

Everyone has heard of Oxycontin, the so-called "Hillbilly Heroin" right? It was created with abuse prevention in mind. If you try to snort it or inject it, an abscess will form at the injection site - BY DESIGN. Seriously, WTF? And it's very expensive too; as is Fentynal, a transdermal patch that releases a synthetic opiate over the course of a few days. Treatment by either of these medications is ridiculously expensive. For legitimate users of the drug, insurance companies charge $900 to $1,500 a month for Oxycontin, and $1,200 to $2,700 a month for Fentynal.

An equivalent amount of pain relief can be delivered by drugs like MS Contin (continuous release Morphine Sulphate - EXACTLY the same strength as Oxycontin) or Hydromorphone (Dilaudid) for literally PENNIES. A single MS Contin pill costs 30 cents, and one Dilaudid costs 15 cents. Obviously someone is making a profit off the suffering of others and at taxpayer's expense.

Yes there is abuse of prescription pain medication, but scientific literature is rife with evidence that education is the best prescription for prevention. Meanwhile, another drug that has been PROVEN effective for pain relief - MORE effective than opiates for certain conditions - is ignored and/or criminalized by the federal government. I'd say which drug that is and provide links to the research, but anyone who has been here for any length of time knows why I can't. I can however (I hope) tell you that it has also been proven in a recent study to shrink lung cancer tumors all by itself by up top 50 percent. Google the important terms in the last sentence to find the study.

If I must wear a label I'm a conservative, yet compassionate, Libertarian; I realize that business must make a profit. I'm all for that, but it must be a fair profit that isn't borne on the backs of the most vulnerable among us as well as the taxpayers. The "compassionate" part comes in with the realization that the poor and disabled MUST be cared for. There is so much waste and fraud on the part of insurers and drug manufacturers, and also insane laws that require physicians to prescribe (in some cases) the latest, most expensive drugs, when cheap generics are available that do exactly the same thing.

Yes, PLEASE put me in charge of reforming Medicare and Medicaid and I'll show you how it's done. It IS possible to keep these programs, and even make them better and more efficient, if special interests are targeted with "laser beam focus," and agencies like the DEA keep their noses out of the doctor/patient relationship, using their vast resources to combat REAL threats to the public health like methamphetamine and heroin instead.

Very good ideas IMO

I'll vote for you as long as you promise to keep your nose away from butts

When are you announcing your candidacy?

Originally posted by Janky Red
Very good ideas IMO

I'll vote for you as long as you promise to keep your nose away from butts

When are you announcing your candidacy?

edit on 4-6-2011 by Janky Red because: (no reason given)

I'll serve if I'm drafted.

And I can PROMISE my nose goes nowhere NEAR any butts.

Always the appropriate question for politicians that want to mess with medicare/meidcaid is.....


"Why should you enjoy prime healthcare at taxpayer expense, while the rest of us are at the mercy of Insurance companies and HMOs"

i wouldnt vote for you

simple fact many states in the union there is no dental or vision for over people 18

but that is rather moot since the federal healthcare law was passed now making everyone who doesnt have insurance buy their own.

another fact of the matter is since the healthcare law medicaid is no longer needed.

and yeah private healthcare is just so bad

i was hospitalized twice both times nearly dying and i incurred over $250,000 dollars in expenses.

all of which i paid zero out of pocket.

Originally posted by neo96
i wouldnt vote for you

simple fact many states in the union there is no dental or vision for over people 18

Shameful isn't it? I did the math two weeks into Obama's Libya campaign. The money he spent on cruise missiles would have paid for start to finish treatment for 80+ victims of lung cancer. Guess how many could have been treated with the 900 million dollars he gave to Hamas - recognized by the State Department as a terrorist organization (a TREASONOUS offense btw) - when he first came into office?

but that is rather moot since the federal healthcare law was passed now making everyone who doesnt have insurance buy their own.

And what about those that can't afford it? I suppose it's a good idea to fine the or send them to jail huh?

another fact of the matter is since the healthcare law medicaid is no longer needed.

You mean the healthcare law that doctors say is doomed to fail? Or the healthcare law that is going to cost trillions of dollars?

and yeah private healthcare is just so bad

i was hospitalized twice both times nearly dying and i incurred over $250,000 dollars in expenses.

all of which i paid zero out of pocket.

Mind if I ask how much you pay in premiums? And you had NO co-pay whatsoever?

What about people who are disabled and struggle to support a family of four on Social Security disability benefits? How are they supposed to pay for this magical healthcare you enjoy?

My hatred of social programs comes down to two things. 1) He who WILL NOT work shall not eat. if it were at all possible to offer the help to only those with genuine short term need, I would be much less opposed. Why should I have my pocket picked by the government to support those who WILL NOT work.

2) A government big enough to give you all things is big enough to take everything away from you. Giving government too much control and power results in loss of freedom and liberty for the people. Socialism requires force. Socialism is you using the armed power of government to steal from you neighbor. To me that is still theft. You are stealing parts of their life in order to fund your own desire to not work. How is that different from slavery?

Originally posted by sonofliberty1776
My hatred of social programs comes down to two things. 1) He who WILL NOT work shall not eat. if it were at all possible to offer the help to only those with genuine short term need, I would be much less opposed. Why should I have my pocket picked by the government to support those who WILL NOT work.

2) A government big enough to give you all things is big enough to take everything away from you. Giving government too much control and power results in loss of freedom and liberty for the people. Socialism requires force. Socialism is you using the armed power of government to steal from you neighbor. To me that is still theft. You are stealing parts of their life in order to fund your own desire to not work. How is that different from slavery?

I'm not taking about those who will not work; I'm talking about those who CAN NOT work. Part of the reforms I would put into place would address this issue.

ETA: OOPS, I forgot I promised my son I'd take him to the movies tonight, a fact he just reminded me of. (Yes, I know I ended a sentence with a preposition. The "right way" sounds too clunky.. Sue me. )

I'll be back to address any further posts later.

reply to post by OldCorp

hameful isn't it? I did the math two weeks into Obama's Libya campaign. The money he spent on cruise missiles would have paid for start to finish treatment for 80+ victims of lung cancer. Guess how many could have been treated with the 900 million dollars he gave to Hamas - recognized by the State Department as a terrorist organization (a TREASONOUS offense btw) - when he first came into office?

i guess spending $2 trillion is just not enough then

And what about those that can't afford it? I suppose it's a good idea to fine the or send them to jail huh?

yell at the idiot who made it federal law wasnt me

You mean the healthcare law that doctors say is doomed to fail? Or the healthcare law that is going to cost trillions of dollars?

agian i didnt write it and the effects will not be seen for awhile.


my healthcare was figured in the hourly thats how they did it so really no idea.

and yeah i paid nothing.

well for those who dont know when and if you become disabled your automatically enrolled in medicare and then those people who get or have to fight for the social security disablity have medicare deducted from the social security checks.

and those who arent there is medicaid.

i didnt make this world i am just like everyone else just a victim as much as anyone else is.

and no hospitla turns away any person needing care.

Originally posted by neo96
reply to post by OldCorp

 

i guess spending $2 trillion is just not enough then

IMO, the money the government spends is being spent on the wrong things. As long as there are homeless, hungry, and people in need of medical care here in the US, the government has no business interfering in the internal affairs of other nations, not they they EVER have any business interfering.

yell at the idiot who made it federal law wasnt me

I'm not yelling at you at all, I'm simply responding to your post that seemed to indicate your support for Obama's "fix."

agian i didnt write it and the effects will not be seen for awhile.

In the meantime, people are suffering and dying, and it's only going to get worse because in order to pay for Obama's 14 trillion dollar deficit, the morons on the Hill are wanting to cut Medicare and Medicaid instead of really looking at it closely to determine where wasteful spending can be cut.

and yeah i paid nothing.

Then you are one of the fortunate few. Most jobs, if they offer healthcare at all, require out of sight premiums and a copay for each service rendered.

well for those who dont know when and if you become disabled your automatically enrolled in medicare and then those people who get or have to fight for the social security disablity have medicare deducted from the social security checks.

You've obviously never applied for Medicare. It is standard practice for the government to deny an applicant's first claim for disability benefits, which is why there are so many commercials on TV for disability lawyers. This is another example of the government interfering in the doctor/patient relationship. If a licensed physician says you're disabled, then the government needs to take the recommendation for benefits as evidence in the claimant's favor. The only people benefiting from this system are lawyers, who typically get 1/3 of the claimant's benefits as compensation for representing them in front of an administrative law judge.

and those who arent there is medicaid.

I thought you said Medicaid wasn't needed.

i didnt make this world i am just like everyone else just a victim as much as anyone else is.

and no hospitla turns away any person needing care.

I'm sorry for whatever accident or illness put you in the hospital, but it seems like you came out just fine. I'd hardly classify you as a "victim."

You are right though: Hospitals do not turn away patients needing emergency care; but who pays for the unpaid bills? You, me, and every other taxpayer. Not only do the hospitals end up getting compensated by tax dollars, they pad the bill with things like a $5 aspirin. I find this especially disturbing because with proper, relatively inexpensive preventative health care, many hospital visits could be avoided altogether.

reply to post by OldCorp

IMO, the money the government spends is being spent on the wrong things. As long as there are homeless, hungry, and people in need of medical care here in the US, the government has no business interfering in the internal affairs of other nations, not they they EVER have any business interfering.

and imo the government should not being giving itself the power of life or death over us and i do agree that the government has no business interfering with the lives of its own citizens without us or our money there is no government or need of one.

In the meantime, people are suffering and dying, and it's only going to get worse because in order to pay for Obama's 14 trillion dollar deficit, the morons on the Hill are wanting to cut Medicare and Medicaid instead of really looking at it closely to determine where wasteful spending can be cut.

yeah they are and i am sure we will disagree with the cause for which i place the blame on the government for killing competition and driving up the costs of healthcare and i do agree with cutting fraud and abuse that runs rampant in this country.

Then you are one of the fortunate few. Most jobs, if they offer healthcare at all, require out of sight premiums and a copay for each service rendered.

in more ways that you will ever know but considering i have worked since the age of 16 every single job i have worked at had health insurance and the fact of the matter is i and many people go decades without ever using it.

ou've obviously never applied for Medicare. It is standard practice for the government to deny an applicant's first claim for disability benefits, which is why there are so many commercials on TV for disability lawyers. This is another example of the government interfering in the doctor/patient relationship. If a licensed physician says you're disabled, then the government needs to take the recommendation for benefits as evidence in the claimant's favor. The only people benefiting from this system are lawyers, who typically get 1/3 of the claimant's benefits as compensation for representing them in front of an administrative law judge.

dont be so sure on that my father is disabled but the age of which he became disabled and his condition he never had to fight for it and yes some people do have to fight for it and yes it is standard practice to deny for some people in this country and not for others.

I thought you said Medicaid wasn't needed

i did since healthcare is now a federal law why is it needed? why is any redundent system needed?

I'm sorry for whatever accident or illness put you in the hospital, but it seems like you came out just fine. I'd hardly classify you as a "victim." You are right though: Hospitals do not turn away patients needing emergency care; but who pays for the unpaid bills? You, me, and every other taxpayer. Not only do the hospitals end up getting compensated by tax dollars, they pad the bill with things like a $5 aspirin. I find this especially disturbing because with proper, relatively inexpensive preventative health care, many hospital visits could be avoided altogether.

dont be sorry crap happens and i dont consider myself to be a victim of that particular circumstance however i do consider myself and the rest of us victims of a corrupt government.

so we should pay twice or three times or how many times as needed?

why should we pay for medicaid and emergency care and other tax dollars that give grants to "health clinics"

how many times must we pay.

Originally posted by neo96
reply to post by OldCorp

 

IMO, the money the government spends is being spent on the wrong things. As long as there are homeless, hungry, and people in need of medical care here in the US, the government has no business interfering in the internal affairs of other nations, not they they EVER have any business interfering.

and imo the government should not being giving itself the power of life or death over us and i do agree that the government has no business interfering with the lives of its own citizens without us or our money there is no government or need of one.

In the meantime, people are suffering and dying, and it's only going to get worse because in order to pay for Obama's 14 trillion dollar deficit, the morons on the Hill are wanting to cut Medicare and Medicaid instead of really looking at it closely to determine where wasteful spending can be cut.

yeah they are and i am sure we will disagree with the cause for which i place the blame on the government for killing competition and driving up the costs of healthcare and i do agree with cutting fraud and abuse that runs rampant in this country.

Then you are one of the fortunate few. Most jobs, if they offer healthcare at all, require out of sight premiums and a copay for each service rendered.

in more ways that you will ever know but considering i have worked since the age of 16 every single job i have worked at had health insurance and the fact of the matter is i and many people go decades without ever using it.

ou've obviously never applied for Medicare. It is standard practice for the government to deny an applicant's first claim for disability benefits, which is why there are so many commercials on TV for disability lawyers. This is another example of the government interfering in the doctor/patient relationship. If a licensed physician says you're disabled, then the government needs to take the recommendation for benefits as evidence in the claimant's favor. The only people benefiting from this system are lawyers, who typically get 1/3 of the claimant's benefits as compensation for representing them in front of an administrative law judge.

dont be so sure on that my father is disabled but the age of which he became disabled and his condition he never had to fight for it and yes some people do have to fight for it and yes it is standard practice to deny for some people in this country and not for others.

I thought you said Medicaid wasn't needed

i did since healthcare is now a federal law why is it needed? why is any redundent system needed?

I'm sorry for whatever accident or illness put you in the hospital, but it seems like you came out just fine. I'd hardly classify you as a "victim." You are right though: Hospitals do not turn away patients needing emergency care; but who pays for the unpaid bills? You, me, and every other taxpayer. Not only do the hospitals end up getting compensated by tax dollars, they pad the bill with things like a $5 aspirin. I find this especially disturbing because with proper, relatively inexpensive preventative health care, many hospital visits could be avoided altogether.

I can't argue with anything above except for the last sentence. Medicaid is NOT redundant. The healthcare law is not even scheduled to go into effect until 2014, yet lawmakers want to cut Medicare and Medicaid NOW. Obamacare will also cover only the most "well off" of the working poor. Many will still not be able to afford it even when it does go into effect.

dont be sorry crap happens and i dont consider myself to be a victim of that particular circumstance however i do consider myself and the rest of us victims of a corrupt government.

so we should pay twice or three times or how many times as needed?

why should we pay for medicaid and emergency care and other tax dollars that give grants to "health clinics"

how many times must we pay.

I'm not sure exactly what you mean buy "health clinics," but the way I see it, services are only rendered - and paid for - once, regardless of where those services are provided. Many services can be provided by nurses or nurse practitioners as well. Obviously, the cost of those services would be cheaper than those provided by an M.D., and preventative health care is WAY cheaper than a visit to an E.R.

I don't think that you and I are really too far apart on this subject TBCH.

If I can be allowed to plagiarize myself: from the other thread:

Originally posted by OldCorp
reply to post by Hemisphere

 

I have to say, I'm impressed with the way Gov. Haley has taken charge of trying to better the Medicaid system in S.C. The article you pointed out did reflect the fiscal reality at the time; however, when more money became available, Haley supported the S.C. House when they restored Medicaid funding a couple of months later. She even went against powerful members of the Senate - from her OWN party who wanted to cut an additional $200 million from the state's threadbare Medicaid program.

State Sen. Tom Davis, R-Beaufort, pushed again Tuesday to trim the budget, arguing for a $200 million cut in the state’s Medicaid program. That money, Davis said, was equal to the deficit that the health care agency for the poor and disabled ran in its current budget year.

Haley has bipartisan support when it comes to making the kinds of changes I proposed in my own thread on Medicare and Medicaid reform.

Some lawmakers are backing a measure that would make it more likely physicians will prescribe cheaper alternative drugs or generics. The Senate approved the measure Thursday.

“There are other drugs that doctors should consider prescribing,” said Republican state Sen. Kevin Bryant, an Anderson pharmacist. “We’ve got three (drug) manufacturers milking South Carolina, making lots of money off three drugs. It needs to end. We have to be responsible to the taxpayers who are funding Medicaid.” Read more: www.thestate.com...

I'll say it again: While the Medicaid program in South Carolina is FAR from perfect, at least Governor Haley is doing her damnedest to make sure that the poor and disabled are getting the most bang for the buck, and she has bipartisan support on the issue. I'm really hopeful that South Carolina will lead the way in reforming these needed programs, so that they don't have to be cut across the board. I'm sorry, but I don't think the same can be

reply to post by OldCorp

I can't argue with anything above except for the last sentence. Medicaid is NOT redundant. The healthcare law is not even scheduled to go into effect until 2014, yet lawmakers want to cut Medicare and Medicaid NOW. Obamacare will also cover only the most "well off" of the working poor. Many will still not be able to afford it even when it does go into effect.

its not a case of want obama already did to fund obamacare and it is also fact that some parts of obama care have already been implimented feel free to not beleive me and internet search is all that will take.

I'm not sure exactly what you mean buy "health clinics," but the way I see it, services are only rendered - and paid for - once, regardless of where those services are provided. Many services can be provided by nurses or nurse practitioners as well. Obviously, the cost of those services would be cheaper than those provided by an M.D., and preventative health care is WAY cheaper than a visit to an E.R.

theres a community health center about 20 minutes away from me my lazy nephew who either can or doesnt want to look for a job went up there for care all footed by the government dime and the kicker is hes under 26 which means he has coverage under his mothers policy.

yeah we not to far apart on this issue but will never have a total agreement.

Originally posted by OldCorp

Drug costs. I'm currently working on a story (for those who don't know, I'm a freelance journalist) about the rules and laws the DEA are forcing down the throats of physicians in the name of the failed "War on Drugs." Physicians are forced to jump through all kind of hoops, and even prescribe unnecessary medications, to provide care for those in chronic pain. In order to prevent "abuse" - less than 3% of chronic pain patients abuse their medications - the DEA uses the idea that it's some kind of epidemic to force doctors to prescribe the latest medications, which are designed to prevent abuse (and maximize profit for Big Pharma,) instead of using cheap generics which are just as, if not more, effective.

Everyone has heard of Oxycontin, the so-called "Hillbilly Heroin" right? It was created with abuse prevention in mind. If you try to snort it or inject it, an abscess will form at the injection site - BY DESIGN. Seriously, WTF? And it's very expensive too; as is Fentynal, a transdermal patch that releases a synthetic opiate over the course of a few days. Treatment by either of these medications is ridiculously expensive. For legitimate users of the drug, insurance companies charge $900 to $1,500 a month for Oxycontin, and $1,200 to $2,700 a month for Fentynal.

An equivalent amount of pain relief can be delivered by drugs like MS Contin (continuous release Morphine Sulphate - EXACTLY the same strength as Oxycontin) or Hydromorphone (Dilaudid) for literally PENNIES. A single MS Contin pill costs 30 cents, and one Dilaudid costs 15 cents. Obviously someone is making a profit off the suffering of others and at taxpayer's expense.

Im a little curious as to where you are getting those dollar figures from. While i agree that there needs to be serious reforms in regards to medicare/medicaid and big pharma and insurance companies, i think you are a little off in those claims. It does not cost near that much for a month's supply of oxycontin or fentynal. Also, the only people that i know of that get brand name drugs like oxycontin and fentynal either are extremely picky and only like brand name drugs and have a good insurance plan or the money to spare, or they are doctor shopping drug seekers that want the OC on their pill and the fentynal box just so they can make extra bucks when they sell it. The legitimate users (the vast majority of people) get the generic versions of these drugs that work just as well. Insurance companies hate having to pay for expensive brand name medicines and will try their best to force the patient to get a cheaper generic. While this helps to self regulate the system in a way, by insurance companies keeping pharmaceutical companies in check, it also has its drawbacks. If a drug has a use other than what it was studied and tested and approved for, it is hard as hell to get your insurance company to cover that drug if you are using it for some other reason, even if that reason is completely legitimate. They will deny the claim at first when it comes through the pharmacy and then the pharmacy has to contact the doctor and then the doctor has to contact the insurance company and explain why the patient needs said medicine rather than some other, cheaper drug. And then they mull it over for a little while (maybe a few hours, maybe a few weeks) before they approve or deny the claim.

The part of the system i dont get is the drug reps. Drug reps are employed by big pharma companies all over, and they visit every doctor's office from rural montana to NYC. Every drug that makes it through clinical trials is assigned, literally thousands, of drug reps. They lobby like hell to all their contacts (all the doctors and pharmacies in their area). Their goal is to get all the pharmacies to order a few bottles of whatever drug it is, and for doctors to write a few Rxs for their new drug. It is bribery. They take your doctor out for a steak dinner and all they want in return is a couple of prescriptions written for their new drug. I am sure we can figure out a better way to keep doctors informed on new drugs other than the drug maker's paying a personal little lobbyist for their drug to go around and tell everyone how great it is. They will have tons of coupons also, so its cheap for the first prescription, or maybe it's a discount card for 6 months or something. A $50 discount for 6 months, sounds great to the patient, sure... But the drug company gets to make it without competition for something like 17 years.

And shortly before their patent runs out, they will come out with an extended release version of the drug, and claim how better and more efficient this new extended release version is over the original drug. The drug reps will push for doctors to switch patients to this new version, and then the cycle continues.

It's all a sham.